Discussion on the law that applies to or affects Australia's emergency services and emergency management, by Michael Eburn, PhD and Barrister.

Paramedics and off duty volunteering – but for who?

I have a question for you and hope you can help. I (and a number of other paramedics) have been approached by a large international motorcycle company to help provide first aid to events they operate. The events involve week long trips into various states and territories within Australia with limited vehicular access. The paramedics would be operating outside of work as volunteers but may be given free accommodation and entrance fee. I have approached my employer who states we would not be legally indemnified if we rendered assistance.

Do you think we would be covered by the Good Samaritan Act in this situation or should we try to gain some form of indemnity insurance?

My employer also states I cannot act at a skill level above basic first aid. After reading many of your articles I get the sense I can act at the level at which I have been trained (ALS) with the equipment available to me at the time. Is this correct?

In the absence of professional registration, describing oneself as a ‘paramedic’ is, I’m afraid to say, legally meaningless. Your employer is correct that you would not be legally indemnified (at least by them) if you undertook this task. There is a notion called ‘vicarious liability’ that says an employer is liable for the negligence of an employee in the course of their employment. The event organizer is not approaching ambulance Victoria or entering an agreement with them so any paramedic doing this job is not acting as an employee of ambulance Victoria so any liability issues would have nothing to do with them.

Whether the event organizer would be liable for any negligence would depend on the nature of the agreement. If the organizer were employing the paramedics there is no issue, the organizer would be liable for any negligence by their employees. If however they are engaging the paramedics as ‘independent contractors’ (and it sounds like that is what is intended) then the paramedics are providing a service to the organizer and would be liable for any alleged negligence.

Do I think you would be covered by the Good Samaritan Act? No I do not. The good Samaritan provisions (Wrongs Act 1958 (Vic) ss 31A-31D) says:

A good samaritan is an individual who provides assistance, advice or care to another person in relation to an emergency or accident in circumstances in which—

(a) he or she expects no money or other financial reward for providing the assistance, advice or care; and

(b) as a result of the emergency or accident the person to whom, or in relation to whom, the assistance, advice or care is provided is at risk of death or injury, is injured, is apparently at risk of death or injury, or is apparently injured.

They go on to say that

A good samaritan is not liable in any civil proceeding for anything done, or not done, by him or her in good faith—

(a) in providing assistance, advice or care at the scene of the emergency or accident…

Arguably as a volunteer you meet that definition but that is not the sort of person that the Act is intended to cover. These provisions were intended to cover people who might refuse to assist at a sudden accident for fear of legal liability; the section is meant to put their mind at ease. By setting yourself up as professionals ready and willing to provide assistance, particularly to a sport that may not be able to proceed without paramedic assistance, you are not, I suggesting acting as good Samaritans. Rather you are doing the task for a reward even if that reward is not payment, it is clearly a ‘job’ that is providing some reward even if it is just the fun of going, the professional challenge and the ‘something different’. Whilst the matter is arguable I think a court would have no trouble holding that you are not a good Samaritan.

You may be protected by the volunteer protection provisions that say ‘A volunteer is not liable in any civil proceeding for anything done, or not done, in good faith by him or her in providing a service in relation to community work organised by a community organisation’ (Wrongs Act 1958 (Vic) s 37). This begs the question of whether ‘a large international motorcycle company’ organizing week long events, presumably for profit, is a community organization. I doubt that it is. Even if it is whether you are volunteering for that organization, or providing a service to it, would depend on the exact terms of the agreement.

My answer to the first question is, in short yes, you should have professional indemnity insurance if you can find anyone that offers such insurance. The problem is that there is no real expectation of private paramedic practice so I would anticipate there would be few insurers who would offer such insurance.

As for skill level, you can do whatever you like provided there is no law against it and it’s got nothing to do with your employer. If you have oxygen, a defibrillator, intubation kit etc you can use them all, but at your risk. The restricted practice is in relation to the use of scheduled drugs. As a Victorian Paramedic the right to carry Schedule 4 and 8 drugs is limited to an ‘operational staff member within the meaning of the Ambulance Services Act 1986’ (Drugs, Poisons and Controlled Substances Regulations 2006 (Vic) reg 5). Given that the anticipated work is with the motorcycle organization and not Ambulance Victoria, that right would not transfer, that is without a personal authorization, or an authorization held by the ‘large international motorcycle company’ you could not carry or use any scheduled drugs.

It is not the place of this blog to provide legal advice but even so, one should note that there is a growing private ambulance profession. A commercial entity seeking to provide motor sports, that I would imagine actually require on site health facilities, should be engaging professional services to ensure that the legal entity of the contracting party is clear, that the terms of the agreement set out who is responsible for what and to provide relevant legal authority for paramedics to practice with the drugs that are part of the tools of their profession. Approaching paramedics employed by Ambulance Victoria may get experienced staff but the details of who is responsible for what, whether the paramedics are working for, or providing a service to the organizer would be unclear. Participants in the race would expect a certain level of professional service and probably equipment so one would have to ask who is going to provide on site ambulances, first aid kits, resuscitation kits etc. What are the medical plans and who is expected to write them? What are the plans to evacuate injured riders from remote areas etc.

These matters may all be addressed in the terms of the offer, but I suggest getting involved in such matters should be left to entities that have set themselves up as being able to provide these services, not recruiting a number of ambulance Victoria employees on an ad hoc basis.

4 thoughts on “Paramedics and off duty volunteering – but for who?”

I , along with many others, have a private paramedicine business. I mainly work overseas. Getting a private medical director is not hard.
The main issue i have seen is people offering to run a first aid post, but, dare i say it, some like saying they are paramedics to the public. This led to an implication that this was the level of service.
Whilst it is said that there is no registration in Australia, there is in fact international registration which is recognised. Even the current laws in SA and TAS have written letters to state they do in fact recognise this international registration. (As do 32 countries)
I digress…. private medical services are significant in Australia and are available. Whilst i do understand what you are intending to do, i would get medical direction for the time period at first aid level. Its not expensive. Are you intending to treat general public or club members only? This is where it gets complicated.
I only offer this information based on being involved in the private sector for many years now.
If i could offer one item of advice….only choose people to help you that are mature enough (read ego) not to be wearing paramedic labels etc. Your a first aider. Has anyone done a risk analysis or history on these events? Google “medical direction” some of the senior emergency department specialist doctors, have a side business of providing services. Most include written CPGs etc.
Private paramedicine is the largest employer of paramedics, medics and cert fours etc.

I approve this comment in the spirit of open debate but I don’t endorse all that is in there. First there can be no such thing as ‘international registration’ as there is no international body that could register paramedics (or anyone else). States may chose to accept that registration in another country is sufficient but that is not the same thing as ‘international registration’. There is nothing in the South Australian law on the issue but it may be that the Minister has granted an exemption to either an individual, or perhaps anyone who holds registration in some other country, as permitted by the Health Care Act 2008 (SA) s 57(1)(c).

Getting a medical director is not the issue. Again the legislation doesn’t call for a medical director, it requires that there is an exemption or permission to use and carry drugs. The department may require a medical director but it is not the case, as is often believed, that appointing a doctor to a position somehow allows that doctor to authorise the use of drugs; that is not the law – see Doctors delegating authority to carry drugs (August 20, 2014).

Calling oneself a paramedic may or may not lead to an expectation of some level of service, save that paramedic is a meaningless term. It means whatever the person using it wants it to mean. I would not recommend googling ‘medical direction’ and approaching anyone who provides a side business of being a medical director for paramedic companies. Apart from it being irrelevant for the purposes of the law, any doctor who want’s to pretend to authorise someone else to use and carry drugs is a shonk.

Interesting article. It seems to announciate many of the pitfalls of offering medical aid in such circumstances.

There are however two aspects of the article whoch baffle me. Firstly, that the event organiser is presumably running the event for profit. Secondly, that such paramedics are sought to be engaged on a volunteer basis.

I know that it is a common sentiment in the emergency services staff have a willingness to do work for little reward. But it does strike me as odd that a profitable enterprise, seeking to engage highly trained staff, would not offer adequate financial compensation.

If I were the paramedic in this scenario, I would insist on the necessary renumeration to cover my legal exposure.

NSW Pharmaceutical Services who issue the licences for Schedule Substances 3, 4 & 8 requires as a minimum an Emergency Care Physician who must be a FACEM, they require extensive protocols, training and accreditation/ reaccreditation review processes and from start to finish, the process took 18 months to obtain our business licences (for internal use only and not commercial profit). There are unfortunately many “paramedics” working privately without adequate protection and often access to scheduled substances that they are legally not permitted to carry and use, albeit in a previous life they may have been.
You only have to enter many of the industrial first aid / medical posts and look in their cabinets, or see the numbers of job adds for “private” paramedic required for construction site etc…….
My advice, leave it to the registered & authorised (NSW Health website lists all business licence holders for verification) Paramedic businesses or the State Ambulance Services / St John Ambulance.